Skip to main content
SpringerLink
Log in

The SF-36: A simple, effective measure of mobility-disability for epidemiological studies

  • Published:
JNHA - The Journal of Nutrition, Health and Aging

Abstract

Background

Mobility disability is a major problem in older people. Numerous scales exist for the measurement of disability but often these do not permit comparisons between study groups. The physical functioning (PF) domain of the established and widely used Short Form-36 (SF-36) questionnaire asks about limitations on ten mobility activities.

Objectives

To describe prevalence of mobility disability in an elderly population, investigate the validity of the SF-36 PF score as a measure of mobility disability, and to establish age and sex specific norms for the PF score.

Methods

We explored relationships between the SF-36 PF score and objectively measured physical performance variables among 349 men and 280 women, 59–72 years of age, who participated in the Hertfordshire Cohort Study (HCS). Normative data were derived from the Health Survey for England (HSE) 1996.

Results

32% of men and 46% of women had at least some limitation in PF scale items. Poor SF-36 PF scores (lowest fifth of the gender-specific distribution) were related to: lower grip strength; longer timed-up-and-go, 3m walk, and chair rises test times in men and women; and lower quadriceps peak torque in women but not men. HSE normative data showed that median PF scores declined with increasing age in men and women.

Conclusion

Our results are consistent with the SF-36 PF score being a valid measure of mobility disability in epidemiological studies. This approach might be a first step towards enabling simple comparisons of prevalence of mobility disability between different studies of older people. The SF-36 PF score could usefully complement existing detailed schemes for classification of disability and it now requires validation against them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ebrahim S, Wannamethee SG, Whincup P, et al. Locomotor disability in a cohort of British men: the impact of lifestyle and disease. Int J Epidemiol 2000;29:478–486.

    Article  CAS  PubMed  Google Scholar 

  2. Harwood RH, Prince MJ, Mann AH, et al. Associations between diagnoses, impairments, disabilities and handicaps in a population of elderly people. Int J Epidemiol 1998; 27:261–268.

    Article  CAS  PubMed  Google Scholar 

  3. International classification of functioning, disability and health. WHO Health Organisation, 2001.

  4. Ebrahim S. Clinical and public health perspectives and applications of health-related quality of life measurement. Soc Sci. Med 1995;41:1383–1394.

    Article  CAS  PubMed  Google Scholar 

  5. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61–65.

    CAS  PubMed  Google Scholar 

  6. Bond, J. and Carstairs, V. Services for the elderly. 1982. Scottish Home and Health Department. Scottish Health Service Studies.

  7. Harwood RH, Sayer AA, Hirschfeld M. Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios. Bull World Health Organ. 2004 Apr;82(4):251–258.

    PubMed  Google Scholar 

  8. Harwood RH, Ebrahim S and Kalache A; Locomotor Disability in The epidemiology of Old Age; London BMJ/WHO 1996: 378–388

  9. Ware JE, Jr., Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998;51:903–912.

    Article  PubMed  Google Scholar 

  10. Prescott-Clarke, P. and Primatesta, P. Health Survey for England’ 96. Vol I: Findings and Vol II: Methodology and Documentation. 1998. London, HMSO.

    Google Scholar 

  11. Ferrucci L, Guralnik JM, Studenski S, et al. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr.Soc. 2004;52:625–634.

    Article  PubMed  Google Scholar 

  12. Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 1992;305:160–164.

    Article  CAS  PubMed  Google Scholar 

  13. Singh JA, Borowsky SJ, Nugent S, et al. Health-related quality of life, functional impairment, and healthcare utilization by veterans: veterans’ quality of life study. J Am Geriatr.Soc 2005;53:108–113.

    Article  PubMed  Google Scholar 

  14. Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55: M221–M231.

    CAS  PubMed  Google Scholar 

  15. Ostir GV, Markides KS, Black SA, et al. Lower body functioning as a predictor of subsequent disability among older Mexican Americans. J Gerontol A Biol Sci Med Sci 1998; 53: M491–M495.

    CAS  PubMed  Google Scholar 

  16. Syddall HE, Sayer AA, Dennison EM et al. Cohort Profile: The Hertfordshire Cohort Study. Int J Epidemiol 2005.

  17. Sayer AA, Syddall HE, Gilbody HJ, et al. Does sarcopenia originate in early life? Findings from the Hertfordshire Cohort Study. J Gerontol 2004;59A:930–934.

    Google Scholar 

  18. Sayer AA, Syddall HE, Dennison EM et al. Birth weight, weight at one year and body composition in older men: findings from the Hertfordshire Cohort Study. Am J Clin Nutr 2004;80:199–203.

    CAS  PubMed  Google Scholar 

  19. Ware JE, Kosinski M, and Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. 2000. Lincoln, RI, Quality Metric Incorporated.

  20. Dallosso HM, Morgan K, Bassey EJ, et al. Levels of customary physical activity among the old and the very old living at home. J Epidemiol Community Health 1988; 42: 121–127.

    Article  CAS  PubMed  Google Scholar 

  21. Lohman TG, Roche AF, Martorell R, eds. Anthropometric standardization reference manual. Champaign, Illinois: Human Kinetic Books; 1988

    Google Scholar 

  22. Mathiowetz V, Weber K, Volland G, et al. Reliability and validity of grip and pinch strength evaluations. J Hand Surg [Am] 1984; 9: 222–226.

    CAS  Google Scholar 

  23. Podsiadlo D and Richardson S. The timed “up & go”: A test of basic functional mobility for frail elderly persons. Journal of American Geriatric Society 39:142–148, 1991.

    CAS  Google Scholar 

  24. Tinetti ME, Inouye SK, Gill TM, et al. Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA 1995; 273: 1348–1353.

    Article  CAS  PubMed  Google Scholar 

  25. E. J. Bassey, M. A. Fiatarone, E. F. O’Neill, et al. Leg extensor power and functional performance in very old men and women. Clin Sci (Lond) (3):321–327, 1992.

  26. R. C. Briggs, M. R. Gossman, R. Birch, et al. Balance performance among noninstitutionalized elderly women. Phys.Ther. 69(9):748–756, 1989.

    CAS  PubMed  Google Scholar 

  27. Martin HJ, Yule V, Syddall HE, et al. Is hand held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with gold standard Biodex dynamometry. Gerontology 2006;52:154–159

    Article  CAS  PubMed  Google Scholar 

  28. Joint Health Surveys Unit of Social and Community Planning Research and University College London, Health Survey for England, 1996 [computer file]. 3rd ed. Colchester, Essex: UK Data Archive [distributor], 26 March 2001. SN: 3886.

  29. Bobak M, Kristenson M, Pikhart H, et al. Life span and disability: a cross sectional comparison of Russian and Swedish community based data. BMJ 2004; 329(7469):767.

    Article  PubMed  Google Scholar 

  30. Kuh D, Bassey EJ, Butterworth S, et al. Grip strength, postural control, and functional leg power in a representative cohort of British men and women: associations with physical activity, health status, and socioeconomic conditions. J Gerontol A Biol Sci Med Sci. 2005 Feb;60(2):224–231.

    PubMed  Google Scholar 

  31. Jenkinson C, Coulter A, Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ 1993;306:1437–440.

    Article  CAS  PubMed  Google Scholar 

  32. Julious SA, George S, Campbell MJ. Sample sizes for studies using the short form 36 (SF-36). JECH 1995; 49: 642–644.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK

    H. E. Syddall, H. J. Martin, C. Cooper & A. Aihie Sayer

  2. Health Services for Older People, Nottingham City Hospital, Nottingham, UK

    R. H. Harwood

  3. University Geriatric Medicine, University of Southampton, Southampton, UK

    A. Aihie Sayer

Authors
  1. H. E. Syddall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. J. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. H. Harwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Aihie Sayer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. E. Syddall.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Syddall, H.E., Martin, H.J., Harwood, R.H. et al. The SF-36: A simple, effective measure of mobility-disability for epidemiological studies. J Nutr Health Aging 13, 57–62 (2009). https://doi.org/10.1007/s12603-009-0010-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-009-0010-4

Key words

Search

Navigation